Traumatic stomatitis: treatment in adults and children
Traumatic stomatitis — an inflammatory process that develops in the mucosa of the oral cavity with her injury and enters the wound of pathogenic or conditionally pathogenic microflora. Stomatitis in children often occurs when razgryzaniya caramel, biting cheeks and lips. In adulthood the disease is caused by trauma, chemical and thermal burns of the oral cavity.
Etiology and pathogenesis
Stomatitis traumatic nature usually occurs on a relatively large wounds mucosa, reduced level of immune protection, a high degree of bacterial contamination of the surface of the gums and teeth. Factors that increase the likelihood of traumatic stomatitis include:
- The lack of adequate hygiene of an oral cavity;
- The use of pastes for cleaning teeth, comprising lauryl sodium sulfate, to reduce production of saliva;
- Medications that reduce the activity of the salivary glands;
- Smoking and frequent alcohol intake;
- The habit of biting her lip and cheek;
- Biting hard objects during meditation (children often bite the end of a pen or pencil).
Minor injuries of the mucous membranes do not usually lead to the development of the disease if the immune defense mechanisms of the person work properly. However, even in this case, the traumatic variety of the disease is possible if the mouth is present the aggressive pathogenic microflora. Similar is true of the Department of purulent surgery and intensive care, neglecting the use of personal protective equipment.
The inflammatory process begins with the appearance of a small area of hyperemia (redness) in the area of previous damage. If the immune defense of the patient is unable to cope with caught in the wound microflora, the process of active development of pathology. Area of hyperemia takes the form of a small ulceration, begins to bleed, the patient experiencing pain. In the absence of adequate treatment develops regional lymphadenitis (inflammation of lymph nodes), there are signs of General toxic syndrome. The infection takes a generalized form. By this time, traumatic stomatitis spreads in the mouth, captures the healthy tissue. Sores can become purulent nature.
Symptoms and diagnosis
The traumatic form of stomatitis is diagnosed on the basis of the following clinical signs:
- Flushing the injury of the mucous membrane;
- Pain is initially localized to the injury;
- The spread of pain to other areas of the mucous membrane;
- The formation of ulcerations or abscesses at the site of trauma;
- Pain when chewing, swallowing, speaking;
- Bad breath;
- Signs of accession fungal infection (white patches on the mucous membrane).
In addition to the specific local characteristics, traumatic stomatitis can cause non-specific symptoms:
- The increase in mandibular lymph nodes;
- Headaches and muscle pain;
- Increased body temperature;
As a rule, stomatitis traumatic nature does not require laboratory tests and are diagnosed based on the clinical picture. However, in some cases, especially in severe disease, patients are prescribed a General blood test and bacteriological examination of washout or smear with lesion pathology.
In the overall analysis of blood marked nonspecific signs of inflammation: increased erythrocyte sedimentation rate, increase in the number of normal white blood cells (leukocytosis), «shift» leukocyte formula to the left. Bacteriological examination allows to identify the lesion, the presence of unusual oral pathogenic microflora and to determine the sensitivity of bacteria to certain antibacterial agents.
In the diagnosis of traumatic stomatitis considerable importance is the medical history. Usually, patients can experience a past trauma of the mucous membrane, nonhealing injuries, burns of the mouth and their chemical lose. It is important that the patient’s denial of fact of injury is not grounds for denial of diagnosis. Sometimes the gateway of infection are cracks in the mucous membranes, to see which patient is not able to.
Examination of patients with traumatic form of the disease requires special attention. In some cases, minor traumatic agent (fish bone) may remain in the wound and go unnoticed for a long time. In this case the treatment will be ineffective or inflammatory process to be resumed shortly after calming down.
In this disease, as traumatic stomatitis treatment starts with eliminating factors, traumatizing the mucosa. They can be a sharp piece of tooth, Tartar, braces, hazardous toys, which the child pulls in a mouth. Traumatic stomatitis often develops in people who use dentures. Last irritate the gums, creating a gateway of infection, as well as contribute to the development of microflora, covering the damaged area from the effects of antiseptic agents. Further treatment can be divided into local and General therapeutic measures.
Local treatment of traumatic stomatitis pursues such goals as:
- Pain relief;
- The removal of inflammation;
- The healing of micro-injuries of the oral cavity.
Pain in the disease easy and moderate severity is achieved by applying local anesthetics. As drugs that reduce sensitivity to pain, can include the following: lidocaine, benzocaine, and tools, which include these substances.
Disinfection of large ulcers may be carried out by the method of penetration and flushing with antiseptic solutions («synthesis», «chlorhexidine», solutions of antibiotics). Such procedures can only be done by a doctor. Small ulcers do not require opening and are cleared spontaneously, as a result of General anti-inflammatory and disinfectant treatment.
Anti-inflammatory effect is achieved by rinsing the mouth with decoction of herbs that have antibacterial and astringent properties (chamomile, oak bark). In addition, the surface of the gums cause the ointment — «holisal», «Metrogil Denta». To reduce the intensity of the inflammatory process and accelerate regeneration can be used sea buckthorn oil, solution «rotokan», «t», etc.
To accelerate the process of regeneration in severe lesions of the mucous membrane may be used in the ointment «solcoseryl». When small ulcerations, which are not causing the patient significant discomfort, the use of this drug is not necessary.
Treat stomatitis with the use of systemic therapy should only be the case if the disease was the cause of the development of General toxic syndrome. To prevent the generalization of the infectious process and the fight against the causative agent of the disease the following groups of drugs:
|Antibiotics.||Before receiving the results of the bacteriological analysis of antibiotics prescribed by empirical method. In this case, the drugs of choice are the means possessing the widest spectrum of action. After determining the sensitivity of the causative agent patient is prescribed an antibiotic to which pathogenic microorganisms are sensitive.|
|Nonsteroidal anti-inflammatory.||NSAIDs are used in hyperthermia, the General deterioration of health of the patient, regional lymphadenitis. Here preference should be given drugs, to a greater extent with anti-inflammatory, not an analgesic effect.|
|Multivitamin complexes.||Taking multivitamin complexes contributes to the increased intensity of the immune defense, increases the body’s resistance to infection, promotes active leakage reduction processes.|
|Immunostimulants and immunomodulators.||Immunostimulants, and especially immunomodulators, traumatic stomatitis are rarely used. Their use is justified in that case, if the child is often sick and has other signs of a weak immune system. When prescribing this group must conduct a thorough assessment of benefit and possible harm from the use of medications.|
Successful treatment of traumatic stomatitis require the patient’s compliance with a certain diet. Patients are not allowed to eat:
- Solid food.
Patients suffering from stomatitis, it is recommended that:
- Eating foods at room temperature;
- The use of softened or chopped food;
- The rejection of the use of juice in its pure form;
- The consumption of juices and fruit drinks diluted with boiled water in the ratio 1:1;
- A mouth rinse with antiseptic after each meal.
Special diet is able to significantly speed up the healing process of the mucous membranes and the disappearance of symptoms.
Among the preventive measures to avoid the development of traumatic stomatitis include:
- Regular hygiene of the oral cavity;
- The rejection of the use of excessively hard foods;
- The refusal of the habit of biting foreign objects or biting the lips and cheeks;
- Timely sanation of wounds for minor injuries;
- Regular medical check-UPS with the determination of the level of activity of the immune system;
- Timely treatment for medical assistance when the first symptoms of the disease.
Sores, despite the apparent lack of seriousness is a dangerous disease and can lead to complications:
Recurrences of traumatic stomatitis after the disappearance of clinical symptoms arise, while maintaining the entrance gate of infection (traumatic factor has not been eliminated) or after the misuse of antibiotics. In the latter case, the pathogen is destroyed before the end continues to grow after the abolition of antimicrobial therapy and leads to a resurgence of the disease.
If untreated, a canker sore is developing rapidly, occupying new areas of the mucosa. The pathogen enters the bloodstream of the patient, spreads to the body and provokes the emergence of new foci of inflammation. In the most severe cases the patient may develop sepsis, which often ends in death of the patient.
Respiratory tract infections
With the active reproduction of pathogenic bacteria, they can get into the respiratory tract. Thus the patient develops laryngitis, bronchitis, tracheitis, pneumonia. The treatment of these diseases is much more complex and painful than timely therapy of traumatic stomatitis.
Uncomplicated traumatic stomatitis in adults, occurs as an independent disease and not associated with serious immune or endocrine disease, is favourable for all forecast. 100% of patients are cured within the first month of therapy. Typically, treatment takes less time.
Therapy stomatitis traumatic nature may be delayed in cases when the disease is caused by an underlying medical condition. The forecast will depend on such the basic disease. So, if traumatic stomatitis develops because of weak immune protection in humans infected with HIV, the prognosis of primary disease adverse.